A significant number of low- and middle-income nations have made HIV/AIDS services more accessible, says a new report – Towards Universal Access – a joint effort by UNICEF (United Nations Children’s Fund), WHO (World Health Organization), and UNAIDS (United Nationion AIDS program). The target, however, was for universal access to HIV prevention, treatment and care by the end of 2010.
After examining HIV/AIDS progress in 144 countries last year, the report reveals that:
- 80% of HIV-positive pregnant women are receiving HIV/AIDS services. Included in those countries are Guyana, South Africa and Botswana. These services, as well as helping the mother, protect the baby from mother-to-child HIV transmission.
- Over 80% of HIV-positive needy children are receiving HIV treatment in 14 nations, including Ukraine, Namibia and Brazil.
- Universal HIV/AIDS healthcare access has been achieved in 8 countries, including Cuba, Cambodia and Rwanda.
Dr Hiroki Nakatani, Assistant Director-General for HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases at the World Health Organization, said:
Countries in all parts of the world are demonstrating that HIV/AIDS universal access is achievable. But globally, it remains an unfulfilled commitment. And we must join forces to make it a worldwide reality in the coming years.
Eastern and Southern Africa, two regions where HIV infection incidence is particularly high, have made “remarkable progress”, the authors of the report inform. In a 12-month period HIV coverage has grown from 32% to 41%. Half of all pregnant females had access to HIV testing and counseling last year in Eastern and Southern Africa.
Dr Paul De Lay, Deputy Executive Director, Program, UNAIDS, said:
We’re on the right track, we’ve shown what works and now we need to do more of it. But we’re US$10 billion short. At the Global Fund replenishment conference in New York next week countries have a chance to put this right – to make a smart investment and secure the future of the AIDS response.
36% of people worldwide in need had access to HIV treatment in low-to-middle income countries in 2009; a 1.2 million increase over the previous year. According to the United Nations, this is the largest 1-year increase ever.
3.91 million people started on ART last year in sub-Saharan Africa, compared to 2.95 million the year before. The percentage of people covered for ART last year was:
- Latin America and the Caribbean – 50%
- Sub-Saharan Africa – 37%
- South and South-East Asia – 31%
- Central Asia and Eastern Europe – 19%
- Middle East and North Africa – 11%
The main difficulties in increasing HIV coverage include a shortage of money, a lack of suitable staff, some health system bottlenecks, and weak procurement and supply management systems for HIV medications and equipment. Interruptions of HIV medication supplies affected one in every three countries last year, according to the report.
More effort needs to be made in order to reach high-risk populations, such as drug users, men who have sex with men, and sex workers. In 2009, just one-third of injecting drug users in low- and middle-income countries were reached with HIV prevention programs.
With only 48% of donated blood being screened in low-income nations, the report stresses the urgent need for improved blood and blood products. In high-and-middle income countries between 85% and 99% of donated blood is screened.
60% of people who were HIV-positive did not know they were, according to a survey of ten countries. Too many people start HIV treatment late because of lack of awareness regarding their HIV status, resulting in more suffering, illness and death.
Dr Gottfried Hirnschall, WHO’s Director for HIV/AIDS, said:
The report findings indicate challenges but also clear opportunities for optimizing investments and increasing efficiency. By starting treatment earlier and improving adherence within the first year, we can save many more lives. We also need to not only further increase access to key HIV/AIDS interventions but also to pay attention to ensure higher quality of these life-saving services.
Although 53% of pregnant women worldwide requiring mother-to-child transmission services were attended to last year – a record – a very large number still lack timely interventions.
28% of needy children globally in 2009 received treatment coverage, the authors inform.
Jimmy Kolker, Chief of HIV and AIDS of UNICEF, said:
Every day, more than 1 000 infants acquire HIV during pregnancy, delivery and breastfeeding. We know how to prevent this. While many countries are now showing significant progress, intensified efforts are urgently needed to reach all mothers and children with the most effective treatment and PMTCT interventions for their own health and for the sake of their communities.
In order to achieve universal access worldwide, the authors say countries need to commit with more money, the integration and linkages between HIV/AIDS and related services, such as TB, maternal and child health, sexual health, etc., need to be improved, and health systems need to be strengthened.
Source: WHO (World Health Organization)
WHO; UNAIDS; UNICEF – 150 pages
Written by Christian Nordqvist